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To assess atrial fibrillation (AF) burden, symptoms and quality of life (QoL) in endurance athletes with paroxysmal AF.
Prospective cohort study.
Otherwise healthy endurance athletes with paroxysmal AF in Norway, Australia and Belgium. The current study presents baseline measurements collected before the intervention of a randomised controlled trial on effects of individually tailored training adaptation.
AF burden (percentage time in AF) was measured by insertable cardiac monitors (Confirm Rx, Abbott). AF-related symptoms and QoL were assessed using the Atrial Fibrillation Effect on QualiTy-of-Life Questionnaire (AFEQT) with any score
43 athletes (age 57±10 (mean±SD), range 33–75 years, 3 women) were included. The athletes were monitored for 50±18 days. Median AF burden was 0.18% (IQR 0%–2.6%). Out of 29 athletes with at least one AF episode, 21 (72%) had AF episodes >60 min. 13 athletes (30%) had AFEQT overall score 60 min were associated with reduced QoL (mean AFEQT score 78 vs 90, p=0.001 and 78 vs 90, p=0.001, respectively). There were large individual variations between the athletes concerning AF burden, symptoms and QoL.
Although most athletes were still competing, more than half had troublesome symptoms. One-third had reduced QoL, which was associated with higher AF burden and longer duration of AF episodes. Variations between the athletes highlight the need for individually tailored AF management in athletes with paroxysmal AF.
Heart failure is an important health problem and patients are generally older with several comorbidities. Multidisciplinary heart failure care is therefore recommended. However, there is little evidence in real-world settings on how to involve primary care health professionals and how to evaluate such programmes. The main objective of this study is to integrate and evaluate several disease management interventions in a primary care setting.
Prospective, non-randomised, observational implementation study with a mixed-methods process evaluation conducted over 3 years (2020–2022).
Primary care practices and two regional hospitals (one tertiary, one secondary) in the Leuven region, Belgium, serving approximately 100 000 inhabitants.
100 general practitioners (GPs) from 19 practices participated. A total of 96 patients were included in the disease management programme. Inclusion criteria for patients included high-risk status for heart failure (HF) readmission, based on clinical criteria. Exclusion criteria were not explicitly defined but participation required informed consent.
Four interventions were implemented: (1) online HF education for GPs, (2) reimbursed natriuretic peptide (NP) testing, (3) patient education by trained primary care HF educators and (4) a structured transitional care protocol posthospital discharge.
Primary outcomes included GP self-efficacy in HF management, NP testing rates, HF registration in electronic health records and patient self-efficacy (9-item European Heart Failure Self-Care Behaviour Scale (EHFScB-9)). Secondary outcomes included patient quality of life (Short Form-12 questionnaire (SF-12)), hospital readmission rates and provider satisfaction.
GPs felt more competent in the management of HF after an online education (eight point increase in self-efficacy score after 6 months follow-up, (CI 2.9 to 13, p
The IMPACT-B study demonstrated that an integrated disease management programme for HF could be implemented and assessed in routine clinical practice. The programme resulted in increased awareness and registration of HF in primary care, increased self-management of patients and improved follow-up after discharge, although these results should be interpreted cautiously given the uncontrolled pre-post study design.
Trial registration NCT04334447 (clinicaltrials.gov).
A skilled and diverse healthcare workforce is essential in nursing homes, yet recruitment and retention remain a major challenge. Gaining insight into the well-being of different care worker groups and how they perceive their work environment can highlight areas of concern and opportunities for improvement.
To compare the perceived work environment and well-being among different care worker groups in nursing homes.
This descriptive study used cross-sectional survey data from the Flanders Nursing Home (FLANH) project, collected from February–July 2023. A total of 1521 care workers from 25 Flemish nursing homes participated (64.4% response rate), including care assistants (43.7%), registered nurses (20.5%), support staff (15.4%), allied health professionals (14.8%), and team leaders (5.7%). Chi-squared tests were used to compare the percentages of the care worker groups reporting the work environment items and well-being outcomes (job satisfaction, intention to leave, burnout). Post hoc analyses were conducted to identify which groups contributed to the significant differences observed.
Significant differences among care worker groups were found for almost all work environment items and well-being outcomes. Staffing adequacy was perceived least among care assistants and registered nurses. More registered nurses and team leaders perceived high workload and emotional burden compared to the other groups. Work–life interference and involvement were perceived most among team leaders. A person-centered vision, work autonomy, and salary satisfaction were reported most among allied health professionals and team leaders. Skill use and training opportunities were reported least among support staff. Work-related well-being appeared to be experienced most among allied health professionals and least among care assistants.
These findings highlight key differences in work environment perceptions and well-being among care worker groups, offering valuable insights for tailored initiatives to foster a supportive workplace that benefits the well-being of all types of care workers in nursing homes.
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